Address correspondence to Timothy Brown, Ph.D., Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California at Berkeley, 2150 Shattuck Avenue, Suite 525, Berkeley, CA 94704; e-mail: email@example.com. Jenny X. Liu, M.A., M.P.P., and Richard M. Scheffler, Ph.D., are with the Petris Center on Health Care Markets and Consumer Welfare, School of Public Health, University of California at Berkeley, Berkeley, CA.
Does the Under- or Overrepresentation of Minority Physicians across Geographical Areas Affect the Location Decisions of Minority Physicians?
Article first published online: 7 MAY 2009
© Health Research and Educational Trust
Health Services Research
Volume 44, Issue 4, pages 1290–1308, August 2009
How to Cite
Brown, T., Liu, J. X. and Scheffler, R. M. (2009), Does the Under- or Overrepresentation of Minority Physicians across Geographical Areas Affect the Location Decisions of Minority Physicians?. Health Services Research, 44: 1290–1308. doi: 10.1111/j.1475-6773.2009.00978.x
- Issue published online: 10 JUL 2009
- Article first published online: 7 MAY 2009
- Geographic/spatial factors/small area variations;
- racial/ethnic differences in health and health care;
- cohort analysis
Objective. To determine whether variation in the representation of minority physicians across geographical areas in California affects the location decisions of minority physicians.
Data Sources. We analyzed data on 9,806 residents and 53,606 patient-care physicians from the 1997–2003 American Medical Association Masterfiles for California along with data from the California Department of Finance, RAND, and other sources.
Study Design. We estimated departure models using linear probability models and destination models using conditional logit. Each model controlled for physician and county characteristics. Parameters of interest include the interactions of physician race/ethnicity with area-level minority physician representation for the corresponding race/ethnicity.
Principal Findings. Departure models show that black and Hispanic physicians are more likely to remain in an area as the level of representation of physicians from their respective groups worsens. The destination models show that black, Asian, and Hispanic physicians tend to move to areas where the level of representation is similar to that of their previous location.
Conclusions. Black and Hispanic physicians are influenced by the level of representation of physicians from their respective groups in their location decisions and tend to locate where needed.